1. 2007

2. Definition  GAD syndrome of ongoing anxiety about events or thoughts that the patient recognises as excessive and inappropriate

3. Diagnostic criteria  Xs anxiety/worry occurring more days than not about a number of events and activities for > 6/12  Difficult to control worry  Associated with 3 or more of  Restlessness  Easily fatigued  Poor concentration  Irritability  Sleep disturbance  Muscle tension

4. Autonomic arousal symptoms  Palpitations  Sweating  Trembling  Dry mouth

5. Symptoms involving chest and abdomen  Breathing difficulty  Feeling of choking  Chest pain  Nausea or abdominal distress

6. Symptoms involving mental state  Dizziness  Unsteady, faint, light headedness  Feeling that objects are unreal (derealisation)  Feeling of loss of control  Fear of dying

7. General symptoms  Hot flushes of cold chills  Numbness or tingling sensations  Muscle tension aches and pains  Restlessness inability to relax  Lump in throat difficulty swallowing

8. Exclusions  Panic disorder  Phobic anxiety disorder  OCD  Hypochondriacal disorder

9. Useful treatments  Psychological  CBT  Anxiety management training  Self help books and CD’s  Pharmacological  SSRI’s  TAD’s  Avoid benzodiazepaines